Surgical Correction of Dysmorphic Uteri

169 Views | Sep 27, 2019

Authors: Michael Sullivan, Cici Zhu, Fatma Alhadhoud, Sukhbir Sony Singh

Affliations: University of Ottawa

Uterine anomalies contribute to impaired fertility, especially pregnancy loss and preterm birth. Dysmorphic uteri is a newly defined class of uterine anomalies characterized by a T-shaped cavity and hypertrophic lateral walls. Pilot studies indicate surgical correction of dysmorphic uteri may improve fertility outcomes.We show three cases of hysteroscopic metroplasty to expand dysmorphic uteri in patients with recurrent pregnancy loss. In two cases, the dysmorphic uteri were initially misdiagnosed as normal on two-dimensional ultrasound, suggesting the anomaly may be underdiagnosed. Relaxing incisions were made along the lateral and anteroposterior walls using a Collins knife. Follow-up hysteroscopic lysis of adhesions were performed as an outpatient. Follow-up three-dimensional ultrasound demonstrated expansion and normalization of the uterine cavity. Dysmorphic uteri are an under-recognized cause of impaired fertility and surgical management may improve fertility outcomes. These cases demonstrate the importance of accurate diagnosis to facilitate appropriate treatment options.